First-time mothers are more hesitant and undecided about childhood vaccinations compared with mothers with children, and only two-thirds of all mothers believe they receive enough information on vaccines during pregnancy, according to a study from the Murdoch Childrens Research Institute, published in Vaccine. Nearly half of mothers pregnant with their first child had concerns about childhood vaccinations and less than three-quarters had made a decision about childhood vaccinations. A disturbing 6% of first-time mothers reported that they had not heard about vaccinations at all. The study aimed to ascertain whether vaccine information is received in pregnancy and post-delivery, mothers’ attitudes and concerns regarding childhood vaccination, and maternal immunisation uptake. It also aimed to determine any correlation between the uptake of childhood vaccines and intentions and concerns regarding childhood vaccination during pregnancy, socio-economic status, concerns regarding pregnancy vaccination, and uptake of maternal influenza and pertussis vaccines during pregnancy. At present, there is no mandated time point in Australia to discuss childhood vaccination with expectant parents, although many antenatal providers discuss hepatitis B vaccine at birth. Midwives in public hospitals, private and public obstetricians and GPs are encouraged to recommend and facilitate pertussis and influenza vaccination in pregnancy. However, the study found that only 46% and 82% of mothers reported receiving pregnancy influenza and pertussis vaccines respectively, confirming that uptake of vaccines in pregnancy is an ongoing challenge. There are no data available in Australia to determine whether vaccine concerns of expectant mothers, particularly first-time mothers, correlate with childhood and maternal vaccine uptake. The study found that the degree of vaccine hesitancy and belief that childhood vaccines are safe during pregnancy correlated with vaccine uptake post-delivery, allowing interventions in pregnancy to be tailored to these specific concerns.

Alcohol industry misleads public on cancer link

The alcohol industry is misrepresenting evidence about the alcohol-related risk of cancer with activities that have parallels with those of the tobacco industry, according to research from the UK published in Drug and Alcohol Review. Alcohol consumption is a wellestablished risk factor for a range of cancers, including oral cavity and liver, breast and colorectal cancers and, according to the researchers, it accounts for about 4% of new cancer cases annually in the UK. Researchers analysed the information relating to cancer which appears on the websites and documents of nearly 30 alcohol industry organisations from English speaking countries around the world between September 2016 and December 2016. They aimed to determine the extent to which the alcohol industry fully and accurately communicated the scientific evidence on alcohol and cancer to consumers. Most of the organisational websites (24 out of 26) showed some sort of distortion or misrepresentation of the evidence about alcohol-related cancer risk, with breast and colorectal cancers being the most common focus of misrepresentation. Through qualitative analysis of this information, they identified three main industry strategies: denying or disputing any link with cancer, or selective omission of the relationship; distortion by mentioning some risk of cancer, but misrepresenting or obfuscating the nature or size of that risk; and distraction, by focusing discussion away from the independent effects of alcohol on common cancers. The most common approach involved presenting the relationship between alcohol and cancer as highly complex, with the implication or statement that there is no evidence of a consistent or independent link. Other strategies included denying that any relationship exists or claiming inaccurately that there is no risk for light or “moderate” drinking, as well as discussing a wide range of real and potential risk factors, thus presenting alcohol as just one risk among many. Professor Mark Petticrew, professor of Public Health at the London School of Hygiene and Tropical Medicine and lead author of the study said: “Some public health bodies liaise with the industry organisations that we analysed. Despite their undoubtedly good intentions, it is unethical for them to lend their expertise and legitimacy to industry campaigns that mislead the public about alcohol-related harms. Our findings are also a clear reminder of the risks of giving the [alcohol industry] the responsibility of informing the public about alcohol and health”.

Helping cancer survivors return to work

A new Psycho-Oncologyanalysis of published studies indicates that there are various employer-related factors that can help or hinder cancer survivors as they attempt to go back to work. The analysis, led by the Amsterdam Public Health Research Institute, included five studies representing the employers’ perspectives and 47 studies representing the cancer survivors’ perspectives. The diversity of the perceived barriers and facilitators related to employer support highlighted in the study indicates the complexity of giving cancer survivors adequate support. In addition, some perceptions of cancer survivors regarding employer support seemed contradictory; for example, survivors mentioned both the need to be supported and the need to be treated normally in the workplace. Also, some survivors perceived an employer who updated colleagues about their sickness as a facilitator, while others perceived such an employer as hindering their work participation. The investigators noted that, to enhance the work participation of cancer survivors, interventions should therefore not have a “one-size-fits-all” approach, but should be adjusted to the survivor’s individual preferences and requirements. To achieve a better work participation, effective employer–survivor communication seems to be a pre-requisite. “This study indicates that employers require certain knowledge and skills to support cancer survivors. This is a useful step towards the development of practical interventions to support employers to fulfil their important and complex role, in order to optimise the return to work of cancer survivors,” said Dr. Michiel Greidanus, lead author of the study.

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Likewise, I am very concerned about the possibility of wider community pressure by some of the groups pushing AGAINST marriage equality. I will vote yes, with strong concerns regarding the higher resources groups advocating a No vote are likely to have for promotion of their stance.